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How Robotics Work in Surgery

Okay. So this is an actual picture of the live surgery. I physically run the robot in a sense that this is like a trigger for a bone saw and my index finger here is on the trigger. You hit the button and the saw then comes into the plane that it’s going to cut and then you hit the button a second time and then the saw blade will actually move. And then what I’m doing is you can see kind of not looking down here, cause you don’t really need to look at the knee. It’s kinda like playing a video game in a sense. That’s why all of the, it’s why the younger generation of surgeons, so to say, has a better time doing this because of all the video games that we have plagued in that I probably does help me a bit.
So then we’re looking at the knee and kind of at this picture here, which is on the monitor up in the room. And you can see when the bone is resected, the green is removed. So that correlates with the amount of bone that’s being resected and you want to make sure that you get the majority of all this with the saw blade. So then, and these parameters, the green border here, the saw cannot go outside of those parameters. So if you try to push it too far to the right or too far to the left, it’s based off of a haptic system and it won’t allow you to go too far to the right or too far to the left. So it’s, it’s very safe to, you’re protecting your ligaments and vital structures in the knee around it. This is another view. You hit the button. Once you’re green, that means go and then you can hit the button again and then you’ll go and resect the green area. Once that completed, that portion of the resection is done. That’s the femur. This is the tibia, the saw blade goes into position, hit the button again, and then you’ll see this is, this blue here is representative of the saw blade and it won’t go too far to the right or too far to the left. It keeps your really controlled and precise into that, that position where the bone needs to be removed.
So over here is the kneecap and the patella tendon. So you can’t get into cutting into that area, prevents, you still certainly need to use soft tissue retractors to prevent any kind of a bumping or or tearing of a vital structures in the knee. But it’s a very safe, safer, I think safer method of doing way of doing this. So then we’re done. We still evaluate the knee, see how it feels, take it through a range of motion, bend the knee up, does the patella track? Well we get full flection. They’re probably 135 degrees for them, full extension. And then, and then when we move the knee around, we can see does it remain well-balanced? Well, here’s 1920 millimeters resection when you stretch the 2122. So their gaps are very well balanced within a half a millimeter to a millimeter. And you get your feedback from when your hands are on examining. And then also the computer feedback. So it’s kind of a check and balance types, a scenario, and this is what the knee replacement looks like when completed. So here’s the femoral component, the plastic on the bearing surface for the tibia, and then the tibial base plate. The kneecap is over here and you can’t really see the plastic on the knee replacement.

February 7, 2018

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